NGHIEN Cl)U LAM SANG k
Nghien cim sire cang doc co tim that trai o ngudi Ion binh thudng bang phuong phap sieu am danh dau md speckle tracking 2D
Nguyin Thj Thu Hoai*, Pham Nguydn Son**, Trin HSi Ydn*, 06 Doan I p i * Vien Tim maeh Viet Nam*
Benh ven Trung uong Quan ddi 108**
TOM TAT
Si^u am tim danh dau mo speckle tracking la mgt ky thuat tiirfng doi mcfi giiip dinh liidng siic cang toan bp that trai cung nhil chiSc nang vimg that trai, De ling dung cac thoi^ s6 danh gia silc cang ctf tim trong thiic t^ lam sang, can co nghien oiu ve cac gia tri binh thUcJng de tham chieu.
Mijc ti^u: Nghien cita siJc cang dpc ccf tim d ngddi Icfn khoe manh binh thilttog va tim hi^u m6i lien quan gifla siic cang doc cd tim thit trai vcfi mot so thong s6 lam sang d cac d6i tiidng nghien oiu nay.
D6i tii^ag va phiioiiig phap: Nghien ciiu diftfc ti^n hanh tr&i 212 ngtfcfl Icfn kho^ mgnh, binh thildng, tuoi tii 20 d^n 79 trong th6i gian tif thang 12/2015 den thang 8/2016. lat ca cdc dfli tifcfng nghign ciiu deu dxidc hoi ti^n sii va cdc tri^u tning, difcfc tham kham lam sang ty mi, lam cdc x^t nghiem theo cdng mot quy trinh chuSn d^ Ioai tni cac benh ly anh hiidng den cau true va chiic nang tim. Sieu am tim thiic*ng quy va sieu am danh dau mo speckle tracking diftfc tien hanh cho tat ca cac ddi tiidng nghien ciiu tren may sieu am Vivid E9 (GE, Hoa Kf) co trang b; phin mem ddnh gia chiic
nang tim bang philtfng phap speckle tracking ddnh gia siic cang dpc toin b^ that trai va silc cang tiing virng that trdi.
K a qua: 103 nam (48,6%) va 109 nS (51,4%).
26,4% cac d6i tifcfng nghien ciiu tuoi tii 20 d^n 29, 31,6% tuoi tif 30 Mn 39,16,5% tu6i tii 40 dgn 49%, 15,5% tuoi tif 50 dgn 59, 7,1% tuoi tif 60 den 69, 2,8% tufli tif 70 den 79. Siic cang dpc cd tim ciJa cac d6i tiiiJng nghien ciiu tif 15,2% den 23,0%, tnmg binh la -19,9 ± 3,7(%). Siic cang dpc ccf tim tnmg binh c* nil la -20,5 ± 2,5(%), siJc cang dpc cd tim trung binh d nam la -19,8 ± 3,1 (%), khong c6 sif khac bigt CO y nghia thdng ke gjtia nam va d nu!
(p > 0,05). Co sii khac biet ve siic cang dpc Cd tim d cac vimg cd tim khac nhau: vimg mom (-22,6%
± 1,5%), viing giiia (-18,5% ± 3,8%), viing ddy (-16,3% ±1,1%) vdi siic cang dpc cd tim thap nhlt d vung ddy tim, tang dan Ien cf vimg gifla tim va vimg mom tim (p<0,05). Siic cang dpc toan bp that trai CO mdi tifdng quan tuyen tinh nghich miic dp vifa v6i can nang (r = -0,42, p<0,05) va vdi huyet dp tam thu(r = -0,46,p<0,05).
Kgtluin: Siic cang doc toan bp that trai 6 ngifdi TAP CHI TIM MACH HOC VIET NAM - S081 2018 I
A NGHIEN ClAJ LAM SANG
Icfn bmh thiftJng la tif 15,2% den 23,0%, trung binh la -19,9 ± 3,7 (%). Siic cang dpc cd tim trung binh d nii la -20,5 ± 2,5 (%). Siic cang dpc cd tim trung binh d nam la -19,8 ± 3,1 (%). Khong cd sii khac biet cd y nghia thdng ke vg siic cang doc cd tim d hai gidi nam va nu! (p > 0,05). Co sii khdc biet co y nghia thdng ke vl siic cang dpc cd tim trung binh cdc thanh dphan day so vdi phan gifla va so vdi phan mom, vcfi siic cang giam dan tif mom tdi ddy (p <
0,05). Siic cang dpc toan bp that trdi cd mdi tildng quan tuygn tinh mile dp vifa vdi can n?ng (r = -0,42, p<0,05) va vdi huyet dp tam thu (r = -0,46, p<0,05).
Tffkhoa: Siic cangdpccdtim,sigu am danh dau mo ccf tim speckle trackmg.
DAT VAN DE
Chiic nang tam thu that trai la m$t ygu td quan trpng trong theo ddi va tien Iddng benh nh4n tim mack Mdt trong cac phiidng phap kinh dign van dtfcic ap d^ng tren lam sang la danh gia phin sd tflng mau EF bang phddng phdp Simpson tren sigu am tim 2D. Tuy nhien, phddng phdp nay phu thuoc vao kinh n ^ g m ciia bdc si lam sieu am nen chiia phai hoan toan khach quan.
Sieu am danh dau md cd tim speckle tracking 2D danh gid siic cang cd tim la mpt ky thu^t tddng dfli mdi cd thg Iddng hod sd bign da^ig cua cd tim trong thdi ky tam thu va tam tnidng. Siic cang mo ta cac thay ddi tddng ddi vg chigu dai gifia hai trang thdi. Cho mdt vat vdi chigu dai ban dau LO dddc keo dai hay nen lai ddcfc chigu dai mdi la L, sde cang quy lidc diidc dinh nghia bang cong thiic Lagrangian.
LL„
£ =
Lo Trong dd: e: Sde cang
L^: Chieu dai ban dau L: Chieu dai tile thW
Siic cang cd tim dddc cho la co f nghia trong
dinh Iddng chiic nang toan bd ding nhd chdc nang vung that trai( 1). Vi^c ilng diing cdc thdng sd ddnh gid siic cang c<S tun trong thdc te Iam sang ddi hdi cd cdc gid trj binh thddng de tham chigu. Tren the gicfi, cd mpt so tdc gid da nghien ciiu ve gid tri binh thiidng cua sde cang cd tim. 0 Viet Nam, cho d6i nay, chiing tdi chda thiy cd nghign ciiu nao vg vdn de nay. Vi vay, chiing tdi tien hanh de tai: "Nghiin aiu sde cang doc ccf tim d ngUifi Uln hmh thuiing bang phUdng phdp sieu dm ddnh dau md speckle tracking 2D" nham hai muc tigu:
1. Nghien oiu siic cang dpc cd tim d ngddi Idn khoe manh binh thddng.
2, Tim hieu mdi lien quan gifla silc cang dpc cd tim that trai vdi mdt sd didng sd Iam sang d cde ddi tddng nghien cdu nay,
DOI TirUNG VA PHUDNG PHAP NGHIEN C0IU Dditiidt^
Chung tdi tign hanh nghien oiu tren nhflng ngddi Idn khoe manh, binh diddng, tudi tfl 20 den 79, tinh nguyen tham gia nghien cflu.
Tieu chuln logi trfl: Chiing tdi khdng lay vao nghien cflu nhflng ngddi dang cd bgnh ndi khoa, nhiing ngddi cd rdi loan nhip tim va rfli loan dSn truygn trgn dign tam dfl, nhiing ngddi c6 hinh anh sieu am md, va nhiing ngdtri khdng ddngy tham gia nghign cflu.
Phiidng phap
Tat ea cac ddi tddng nghign cflu dgu ddt^c hoi tign sflva cac trieu tning, dddc tham khdm lam sang ty mi, lam cde xet nghidm mau, chup X-quang tim phdi, lam dien tira dd, Iam sigu am tim de logi trfl cac benh ly anh hddng den cau tnic va chflc nang tun, do chieu cao, cdn nang, do huygt ap va nhip tim theo cimg mot quy trinh chuln. Sigu 4m tim thddng quy dddc tign hanh de loai trfl cac bat thddng vg elu tnic va chiic nang tim nhd phi dai thit trai, cdc rfli loan van dflng vimg thanh tim, cac benh van tim, 10 ITAPCH1TIMMACHHOCVIETNAM-SO81.20I8
NGHIEN C\JU LAM SANG k
cdc bgnh tim bam sinh, cac benh cd tun, bgnh mang ngoai tim...
- Phddng tien nghign cflu: Mdy sieu am Vivid E9 (GE, Hoa Ky) cd trang bi phin mgm danh gia chflc nang tim bang phddng phap speckle tracking.
- Quy tiinh thiic hign sieu am speckle tracking;
+ Bddc 1: Ghi hinh ddng theo thfl td mat cat 3 budng, 4 budng, 2 budng true dpc trong it nhat 3 chu ky v<S tde do quet 60 -100 anh/giay
+ Bddc 2: Phan tich hinh anh dpng bang phSn mem AFI co san trgn may sieu am: Vdi mdi m£it cat, chpn 2 dlgm d vdng van hai la va 1 digm d mdm tim, sau do may se tfl ddng vi^n theo ndi mgc tim, tuy nhien can phai digu chinh de cd ket qua chinh xac nhat Sau dd may se td ddng phan tieh dg tim ra dinh siic cang dpc toan bd thit trai va dinh sflc cang dpc cua tdng vimg trong thi tam thu.
Hinh anh cudi cung thu dddc gpi la hinh anh buU's eye. Toan bg thit trai dddc chia thanh 17 vimg theo khuygn cao cua Hiep hpi Sigu am Tim Hoa Ky( 1).
Hinh 1. Mmh hoa phUdngphdp ddnh gid stic cdng cd Um hiing situ dm tim ddnh d&u mo speckle tracking
• Dia diem tien haiih nghign eilu: Vign Tim maeh Viet Nam - Benh vign Bach Mai, Ha Nfli.
- Phiidng phap xd Iy sd lieu: Bang ede thu|t todn tfiflngkg trgn mayvi tinh vdi phan mim Stata 14.0.
KET QUA
D|c digm chung cua cdc ddi tddng nghign cilu:
Trong thdi gian tif thang 12/2015 dgn thdng 8/2016, chiing tfli tign hanh nghign cflu trgn 212 ngddi Idn tfl 20 dgn 79 tudi, bao gflm 103 nam
va 109 nfl (51,4%). Sflc cang dpc ed tim cua cdc doi tddng nghien cflu tfl 15,2% dgn 23,0%, trung binh la-19,9 ± 3,7 (%).
20-29 30-39
Bieu do 1. Phdn h6 tu6i ciia cac doi tuang nghi&n cdu Nh4n x&t: 26,4% cac ddi tfldng nghign cflu tudi tfl 20 dgn 29, 31,6% tufli tii 30 dgn 39,16,5% tuoi tfl 40 den 49%, 15,5% tudi tfl 50 den 59, 7,1% tufli tfl 60 dgn 69,2,8% tudi tfl 70 den 79.
Bdng I. Mgt so dac diim ldm sdng vd stiu dm tim thudng quy cda cdc d6i tU(?ng nghien cdu
Mpt s6 dac diem lam sang va sieu am tim thudng quy
Gldl Chi^ucao(aTi) C ^ n 3 n g ( l ^ ) Tan s6 tim (clc/phiit) Huy^t ap tam ihu (mmHg) Huyet ap tam tnidng (mmHg) Be day vach lien that tiim tntdng (mm) Be day thanh sau that trai t ^ trUdng (mm)
Ketqua Nii n(%)hoac
X+SD 109(51,4%)
154,6+7,8 51,5±9,4 72,2 ±8,7 116,5±11,4
71,7 + 8,8
8,2 ±1,6
7,9+1,4 Nam n(%)hoac
X±SD i03 (48,6%)
162,5±8,2 56,5±10,2 69,6 ± 9 4 118,7 ±16,4
82,3*7,1
8,7 ±1,9 8,1 ± 1,7
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Dudng kinh that trai cu6i tam tru'dng (mm) Thg tich that trai cui3i tam trUdng (ml) Phan s6 tdng mau thit trai EF(%)
\ ^ toe songE van hai la (cm/s) Van toe sdngA van hai la (cm/s)
Thdi gian giam toe sdngE van hai la (ms) Thdi gian gian dong the tich thit trii (ms)
\ ^ tdc song E' tai chan vdng vanhaila (cm/s)
45,1 ±4,8
97,7 ±11,5 63,9 ±7,3 74,5±21,4 52,6 ±16,3 205,7 ±56,3
83,3 ±21,6 7,5+2,1
47,3 ±3,9 10S,9±21,6 65,7±10,2
69,7 ±19,5 51,6±16,7 214,5±72,9
98,1 ±234 8,5 ±2,3
Bang 2. Mt qud sde cdng dgc todn bd that trdi theo tu6i vd^di
JVh^nx^:Trongsd212cdcdflitddngnghignciiu, ty le nam/nfl tddng dfldng nhau (48,6%/51,4%).
Cac thflng sfl vg chieu eao, can nang, huyet dp va tan sd tim dgu trong gidi ban binh thddng d ca hai gidi, Cac thflng sfl vg kich thddc va chflc nang tim d hai gidi cung deu trong gidi han binh thddng.
Bdng 3. Kit qud siic cdng doc ccf tim theo tiing viing that t Cacohom
Ongildi<40tu6i (nC/nam: n=67/n=56) 0 ngndi40-S9mdi (nii/nam; n=32/n=36) 0 ngudi > 60 tuoi (na/nam:n.lO/n=ll) Trung binh ctia tat ca cac doi tuong nghien ciiu (nii/nam;n=109/
n.l03)
Siltc ding d o c t o r bo that trai (%)
Nfl -21,7±
1,3 -19,5 ±
1,5 -16,5 ±
1,2 -20,5 ±
2,5 Nam -20,9 ±
2,0 -18,8±
1,6 -16,3±
1,1 -19,8 +
3,1 P
>0,05
>0,05
>0,OS
>0,0S
Nh4n xH: Sflc cang dpc ed tim trui^ binh d nfl la -20,5 ± 2,5(%). Sflc cang dpc ed tim trung binh S nam la -19,8 ± 3,1 (%). Khdng cd sd khde biet cd y nghia thdng kg gifla sflc cang dpc cd tim d nam va d nfl (p > 0,05).
Thanh trudc Vach Len that nudc Thanh dU6i Thanh b^n Thanh sau Vach lien that Tmng hlnh cac thanh
Vimg mom (%) -21,7 ±2,9 -19,3 ±3,2 -18,7±3,2 -21,5±1,7 -18,6±2,8 -17,5 ±3,2 -22,6±1,5
Vuog gifla (%)
-19,5 ±3,7 -19,3 ±2,9 -20,5 ±2,5 -20,7±2,1 -19,3 ±2,7 -17,4±3,6 -18,5±3,8
Vangd4y(%)
-18,7±3,3 -20,8 ±2,1 -18,5 ±3,7 -18,6±2,9 -17,5 ±3,1 -16,7±1,7 -16,3 ±1,1*
Trung binh Ciicvimg(%)
-19,5±4,4 -19,7 ±3,5 -18,5±3,2 -20,7 ±5,1 -18,5±4,2 -17,2±3,8 -18,9±2,2
*p< 0,05 so sdnh gifla vimg day vdi vimg gifla va vung mom.
Nhqn xet: Cd sd khae biet ve sflc cang dpc cd tim d cdc vung cd tim khac nhau (mdm, gifla, day). Sflc cang dpc cd tim thap nhlt d vung day tim, tang din Ien d vimg gifla tim va vimg mdm tim (p<0,05).
12 ITAP CHi TIMMACH HOC VIET NAM-SO81.2018
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Bdng 4. Moi tUOngquan giiia siic cdng dgc todn bd th&t trai vdi m$t so thong sd ldm sdng.
Chi^u cao Can nang Huyet ap tam thu Huy^t ap tam truong Tan sd tim
He sd tiiOngquan r
0,12 -0,42 -0,46 -0,17 0,18
P
>0,05 0,012 0,023
>0,05
>0,05 Mi^n xet: Sflc cang dpc toanbfl that trdi cd mdi tflcftig quan tuyen tinh n ^ e h mflc dfl vfla vcfi can nang (r = -0,42, p<0,05) va vdi huygt ap tam thu (r = -0,46,p<0,0S).
BAN LUAN
Trong hem mdt thap ](y qua, sd phdt trien cua ky thuat sieu am danh dlu md speckle tracking da cho phep danh gia sau sac nhiing van dpng cd hpe eua that trai, sfl thay ddi vg sflc cang cd tim toan bd va tifng vung, Viec nghien cdu ve gid tri binh thfldng cua sflc cang cd tim ed y n ^ a quan trpng trong thflc hanh Iam sang va trong cdc nghien cflu tim maeh.
Ddi tfldng nghign cdu cua chung tdi gdm 212 ngddi Idn binh thddng, trong do cd 48,6% nam gidi, 51,4% nfl gidi. Ty lg nam/nfl trong nghign cflu cua chung tdi phu hdp vdi ty le nam/nfl trong dan sd VietNam(2,3).
Phin bfl tudi cac ddi tfldng nghign cdu tudi gdm 26,4% tfl 20 dgn 29,31,6% tudi tfl 30 defn 39,16,5%
tufli tif 40 den 49%, 15,5% tudi tfl 50 dgn 59, 7,1%
tudi tfl 60 den 69,2,8% tuoi tfl 70 den 79, Phan bd tudi trong nghien cflu cua chiing tdi phu hdp vol ed elu tufli trong dan sd VietNam nam 2016(4).
Trong nghign cflu eda chung tdi, sflc cang dpc toan bp thit trdi trung binh la 19,9 ± 3,7(%), nam trong ph^m vi tfl 15,2% dgn 23,0%. Nghign cflu cua
Marwiek eho thiy sflc cang dpc cd tim trung binh la -18,6 ± 0,l(%)(5). Nghien cdu tdng phan tich cfla Yingehocharoen trgn 2597 ngfldi binh thfldng qua 24 n ^ e n cflu cho thiy pham vi binh diflcftig cua sfle cang dpc toan bd that trai tfl 15,9% den 22,1%(6). Nhli vay, kgt qua nghien cflu cda ehiing tfli cung tfldng tfl vdi kgt qud cua cdc nghien cflu tren thg gidi.
Trong nghien cflu cua chung tdi, sflc cang dpc toan bd that trai d nfl gidi la -20,5 ±2,5 (%), d nam gidi la -19,8 ± 3,1 (%), khdng cd sfl khdc biet cd f nghia thflng ke gifla sfle cang dpc ed tim d nam va d nfl (p>0,05), Nghien eiiu tflng phdn tich cua Yingehocharoen tren 2597 ngfldi binh thfldng qua 24 nghien cihi cung cho thay khflng cd sfl khac biet ed f nghia thdng ke ve sflc cang dpc ed tim gifla nam va nfl(6). Mflt sfl nghign cdu khac cho thiy chi ed sfl khdc biet chut it ve sfle cang dpc cd tim gifla hai gidi, nfl cao hdn doi chut so vdi nam(7). De giai thich dieu nay, chiing tdi cho ring eae nghien cflu sfl dvmg cdc hg thdng mdy sigu am khac nhau, phddng phap danh gid eiing cd khac nhau.
Nghien cflu cua chung tdl cho thay tufli cang cao thi sflc cang doe ed tim cd xu hddng giam dan d ca hai gidi. Tuy nhien, do nhdm tufli >60 cd it dfli tddng nghien cflu nen chung tdi khdng dfla ra dddc sfl khac bigt co y nghia thflng ke. Nghien cflu HUNT tai Na Uy tren 1266 ngddi khoe m^nh binh thddng cho thay sflc cang dpc cd tim giam dan khi tudi cang cao, dfl do bSng phdcftig phap sieu am tim danh d^u md speckle tracking hay do bang phfldng phap sieu am Doppler md cd tim. Nhflng thay ddi theo tudi nay la nhi^g thay ddi sinh Iy, tfldng tfl vdi nhiing thay ddi ve chflc nang tam tnidng, chflc nang tam thu that trai da dddc cac nghien cflu trddc day chiing minh qua cac bSng chflng ve bien doi cua do day thit, cua van tdc sdng E', dp dich chuyen vdng van hai la theo tudi(7,8).
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Nghien cflu cfla ehiing tdi cho thay ed sfl khde biet cd y nghia thflng ke vg sflc cang dpc cd tim trung binh cdc thanh d phin day so vdi phin gifla va so vdi phin mdm, vdi sflc cang giam dan td mom tdi day (p < 0,05). Ket qua cfla ehung tfli tddng td vdi kgt qua cda tae gia Marwiek khi nghign cflu tren 250 ngdcft binh thddng (5). Cdc phfldng phdp ddnh gia sflc cang c<S tim khac nhau cd the cho kgt qua khd khdc nhau ve sfl dong bp ve sflc cang cd tim tfl mom dgn ddy. Phfldng phdp cdng hfldng tif bait nhan va phfldng phap sigu am ddnh dau mfl speckle tracking deu cho thiy sfle cang dpc cd tim cao nhat d phin mdm va giam dan vg ddy tim. Phfldng phdp sieu am Doppler mo ed tim lai khdng cho thiy sfl khac biet vg sfle eang dpc cd tim tif mflm tdi day, dieu ndy efl dig do sfl ph\i thude cua sflc cang ed tim vao gde cua churn tia sigu am khi danh gid bang sigu am Doppler mdcdtim(9,10).
Ket qua nghign cflu cfla ehiing tdi cho thay cd sfle cang dpc toan bfl thit trdi co mdi tddng quan tuyen tinh mflc dp vfla vdi can nang (r = -0,42,
p<0,05) va vdi huyet dp tam thu (r = -0,46, p<0,05).
Ket qua nay cung tfldng tfl vdi ket qua cua tdc gia Marwick(5).
KET LUAN
Qua nghign cflu sflc cang dpc Cd tim d 212 ngdcfl idn binh thfldng tfl 20 den 79 tufli gdm 103 nam (48,6%) va 109 nfl (51,4%), chung tdi nhan dily:
1. Sflc cang dpc toan bfl that trai d ngfldi Idn binh thfldng la tfl 15,2% dgn 23,0%, tnmg binh la -19,9 ±3,7 (%). Sflc cang doc cd tim trung binhdnfl la -20,5 + 2,5 (%). Sflc cang dpc ed tim trung binh d namla-19,8±3,l(%).
2. Khdng cd sd khac biet cd ^ nghia thflng kg ve sflc cang dpc ed tim dhai gidi nam va nfl (p > 0,05), Cd sfl khde biet cd y' nghia thflng ke ve sflc cang doc ed tim trung binh cdc thanh d phan ddy so voi phan gifla va so vdi phan mdm, vdi sflc cang giam din tif mdm tdi day (p < 0,05). Sfle eang dpc tPan bfl tiiat trai ed mdi tfldng quan tuygn tinh mflc dfl vfla vcfl can nang (r = -0,42, p<0,05 ) va vdi huygt ap tam thu (r = -0,46,p<0,05).
ABSTRACT
Left ventricular s^mental and ^obal longitudinal strain based on 2D spedde tracking echocardiography in healthy adults
N^yen Thi Thu Hoai, Pham Nguyen Son, Tran Hai Yen, Do Doan Loi The definition of normal values of left ventricular longitudinal strain is of critical importance to tiie clinical application of this modality.
Aims: To investigate global and regional left ventricular longitudinal strain in healtiiy adults and to study the relations between left ventricular longitudinal strain and some clinical parameters.
Methods: From 12/2015 to 8/2016, 212 healthy adults were included. Detailed clinical and biochemical examination, standard echocardiography were performed in each individual to exclude any underlying pathology that could alter cardiovascular structure and function. Echocardiography was performed with GE Vivid E9 (USA), Speckle tracking echocardiography images were analyzed to assess global longitudinal strain and regional longitudinal stram by AFI software (GE, USA).
Results: Male: 103(48,6%), female: 109 (51,4%). 26,4% aged 20-29, 31,6% aged 30-39,16,5% aged 40-49, 15,5% aged 50-59, 7,1% aged 60-69, 2,8% aged 70-79 (years). Global longitudinal strain ranged firom 15,2% to 23,0%, average global longitudinal strain of all subjects was-19,9 + 3,7(%), there were no significant dilFerenee between male and female: male -19,8 ± 3,1 (%) vs. female -20,5 ± 2,5(%), (p>0,0S).
14 [TAPCHl'TIMMACHHOCVIETNAM-SO81.2018
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There were significant differences between means across basal (-16,3% + 1,1%), middle (-18,5% ± 3,8%) and apical (-22,6% ± 1,5%) segments, (p<0,05). Global longitudmal strain correlated moderately with weight (r = -0,42, p<0,05) and with systolic blood pressure (r - -0,46, p<0,05).
Conclusions: Global systohc strain (mean + SD) was -18.6 ± 0.1%, ranged from 15,2% to 23,0%, there were n o significant difierence between male and female: male -19,8 ± 3,1 (%) vs. female -20,5 ± 2,5(%), (p>0,05). Regional systohc strain differed significantly between basal, middle, and apical segments: -16,3%
± 1,1% vs. -18,5% ± 3,8% vs. -22,6% ± 1,5%, p<0,05, respectively, with the basal strain was the lowest and increased gradually from basal to apical regions. Global longitudinal strain correlated moderately with weight and systolic blood pressure, r = -0,42, p<0,OS and r = -0,46, p<0,05, respectively.
Keywords: Global longitudinal strain, speckle tracking echocardiography.
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